Endocrine and metabolic aspects of COVID-19.
Study Goal
The researchers aimed to explore the potential role of melatonin in mitigating age-related hormonal deficiencies that may contribute to COVID-19 morbidity/mortality in older individuals.
Results Summary
The study hypothesizes that melatonin, along with other hormonal deficiencies, may influence COVID-19 outcomes in older patients, suggesting its probable usefulness as an adjuvant therapy, though clinical trials are needed for confirmation.
Population
Older individuals with age-related hormonal deficiencies, particularly melatonin and dehydroepiandrosterone.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
SARS-CoV-2 binding to ACE2 | decrease | ACE2 enzyme levels | - | - | leads to the downregulation | #1 |
SARS-CoV-2 binding to ACE2 | increase | angiotensin II and aldosterone | - | - | leads to the excess | #2 |
ACEI and ARB | increase | COVID-19 infection outcome | - | - | could be presumed beneficial effects | #3 |
local RAS dysregulation in adipose tissue | increase | obesity as a risk factor of severe outcome | patients with COVID-19 infection | - | is the main cause of the negative role | #4 |
age-related hormonal deficiencies | increase | morbidity/mortality | older people | - | may contribute to | #5 |
melatonin | increase | COVID-19 infection outcome | - | - | usefulness as adjuvant drug is probable | #6 |
angiotensin converting enzyme inhibitors/angiotensin receptor 1 blockers | increase | COVID-19 infection outcome | - | - | usefulness as adjuvant drug is probable | #7 |
The paper presents the theoretical considerations on the role of endocrine and metabolic alterations accompanying COVID-19 infection. These alterations may be presumed on the basis of the following two observations. Firstly, the virus SARS-CoV-2 responsible for the COVID-19 infection uses an important renin-angiotensin system (RAS) element - angiotensin-converting enzyme 2 (ACE2) - as a receptor protein for entry into target cells and, in consequence, disturbs the function of the main (circulating) renin-angiotensin-aldosterone system (RAAS) and of the local renin-angiotensin system localized in different tissues and organs. The binding of SARS-CoV-2 to ACE2 leads to the downregulation of this enzyme and, in the aftermath, to the excess of angiotensin II and aldosterone. Thus, in the later stage of COVID-19 infection, the beneficial effects of ACEI and ARB could be presumed. It is hypothesized that the local RAS dysregulation in the adipose tissue is the main cause of the negative role of obesity as a risk factor of severe outcome of the COVID-19 infection. Secondly, the outcome of COVID-19 strongly depends on the age of the patient. Age-related hormonal deficiencies, especially those of melatonin and dehydroepiandrosterone, may contribute to morbidity/mortality in older people. The usefulness of melatonin and angiotensin converting enzyme inhibitors/angiotensin receptor 1 blockers (the latter only in later phases of the infection) as adjuvant drugs is probable but needs thorough clinical trials.